On July 10, the Centers for Medicare & Medicaid Services (CMS) announced a new radiation oncology model to be introduced in early 2020. The model proposal states that CMS would make bundled payments to cover 90-day episodes of radiotherapy services for 17 types of cancer based on patient diagnoses. Medicare data would be utilized to assess outcomes compared to the current fee-for-services payment arrangement.
Participation in the 5-year model would be mandatory for radiation oncology providers randomly selected from Core Based Statistical Areas (CBSAs). Payments to participants would be linked to quality metrics, including clinical data reporting and patient experience.
According to the proposal, episode payments would be split into a professional component for physician services and a technical component for equipment, supplies, personnel, and other non-physician costs. This division would acknowledge that professional and technical services are sometimes furnished by separate providers or suppliers.
Assuming the radiation oncology model launches as proposed, participants can expect that the MedBen Analytics platform will be ready to furnish actionable reporting that will help them maximize the value of bundled payments. As we receive more specific information about the model, we will make the necessary additions to our software.
MedBen Analytics will provide further information and share observations on the new model as we receive it. In the meantime, if you have any questions or are interested in viewing a demo of our current reporting platform, please contact Manager of Operations Cari Coventry at 800-423-3151, ext. 405 or ccoventry@medben.com.